便携式凝血仪在抗凝治疗监测中的应用

目的探讨重叠使用低分子肝素和华法林抗凝以及单独使用华法林抗凝时便携式凝血仪检测国际标准化比值(INR)的应用。方法对于重叠使用低分子肝素和华法林抗凝以及单独使用华法林抗凝的静脉血栓栓塞症患者,采用便携式凝血仪和实验室自动化仪器分别同时检测INR,分析两种方法的相关性和采用便携式凝血仪的偏倚度、准确度。结果重叠抗凝组和单独抗凝组使用便携式凝血仪检测的INR与实验室INR的相关系数分别为r=0.965和r=0.866(P<0.01),重叠抗凝组的偏倚度高于单独抗凝组(分别为0.19±0.58和0.02±0.53),重叠抗凝组和单独抗凝组的两种INR检测方法的准确度分别为80.0%和88.9%。结论重叠使用低分子肝素抗凝时和单独使用华法林抗凝时,便携式凝血仪检测的INR与实验室检测的INR有良好的相关性和准确度。低分子肝素重叠抗凝时,用便携式凝血仪检测INR的偏倚度高于单独华法林抗凝组。

The application of point - of- care testing for anticoagulatlon monitoring.

Objective To evaluate the significance of point -of- care testing （POCT） in patients receiving treatment of low molecular weight heparin （LMWH） bridging with warfarin or warfarin alone. Methods International normalized ratio （INR） of patients with venous thromboembolism received warfarin combined LMWH or warfarin alone was tested by POCT or laboratory automatic method. Correlation, bias and accuracy of these two testing methods were analyzed. Results In bridging anticoagulation group and warfarin anticoagulation group, the correlation coefficients of these two methods were 0.965 and 0. 866 （ P 〈0.01 ） respectively. The bias of bridging anticoagulation group was higher than that of warfarin anticoagulation group. The degrees of accuracy of POCT in two groups were 80.0% and 88.9% respectively. Conclusion In bridging anticoagulation group and warfarin anticoagulation group, the correlation of these two methods is well. The accuracy of POCT is high. The bias of POCT in bridging group is higher than that of warfarin group.